Food avoidance in children with adverse food reactions: Influence of anxiety and clinical parameters

Authors

  • Thuy-My Le,

    Corresponding author
    • Department of Dermatology & Allergology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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    • T-M Le and WT Zijlstra equally contributed to the manuscript.
  • Wieneke T. Zijlstra,

    1. Department of Medical Psychology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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    • T-M Le and WT Zijlstra equally contributed to the manuscript.
  • Eveline Y. van Opstal,

    1. Department of Dermatology & Allergology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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  • Mirjam J. Knol,

    1. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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  • Monique P. L'Hoir,

    1. TNO Prevention and Health, Leiden, The Netherlands
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  • André C. Knulst,

    1. Department of Dermatology & Allergology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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  • Suzanne G. M. A. Pasmans

    1. Department of Dermatology & Allergology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
    2. Pediatric Dermatology, Erasmus Medical Center, Rotterdam, The Netherlands
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Correspondence

Thuy-My Le, Department of Dermatology/Allergology, University Medical Center Utrecht, G02.124, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands

Tel.: +31 88 7557988

Fax: +31 88 7555404

E-mail: t.t.m.le-2@umcutrecht.nl

Abstract

Background

Many children in the general population avoid food because of self-reported adverse food reactions (AFR). Food avoidance can have negative consequences for well-being and nutritional status. This study aimed to investigate which factors are related to avoidance behavior in children (10–13 yr old) from the general population.

Methods

Questionnaires for both mother and child were sent to participants from the Europrevall study: 164 children with self-reported AFR and 170 children without AFRs. Spielberger state anxiety and trait anxiety and clinical parameters, such as severity of the adverse reaction, specific IgE and doctor's diagnosis, were compared between those who have (had) AFR and avoid food (i.e., avoiders) and those who have (had) AFR(s) and do not avoid food (anymore; i.e., non-avoiders).

Results

In total, 59% of the children with AFRs avoided food, of whom 26% had positive specific immunoglobulin E (sIgE). Child's state anxiety about an AFR was higher in avoiders than in non-avoiders, (p < 0.001), whereas child's trait anxiety and maternal state anxiety and trait anxiety were comparable in both groups. Avoiders reported more often severe symptoms (i.e., generalized urticaria, respiratory or cardiovascular symptoms) than non-avoiders, (p = 0.03). Food avoidance was not associated with doctor's diagnosis of food allergy or doctor's advice to avoid food (p = 1.00).

Conclusion

Food avoidance is related to child's state anxiety about an adverse food reaction. Food avoidance seems to be independent of a doctor's diagnosis of food allergy and advice on food avoidance.

Ancillary